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Liver status and outcomes in patients without previous known liver disease receiving anticoagulant therapy for venous thromboembolism

2021; Springer Science+Business Media; Volume: 17; Issue: 3 Linguagem: Inglês

10.1007/s11739-021-02858-x

1970-9366

Diego Martínez‐Urbistondo, Rocío García de la Garza, Paula Villares-Fernández, Carme Font, Sebastian Schellong, Juan J. López-Núñez, A. Gil-Díaz, Carmen Díaz‐Pedroche, Jana Hirmerová, Manuel Monréal, M.D. Adarraga, Jesús Aibar, J. Alonso, Cristina Amado, J.I. Arcelus, A Asuero, Aitor Ballaz, Raquel Barba, C. Barbagelata, M. Barrón, B. Barrón‐Andrés, Á. Blanco-Molina, Fahd Beddar Chaib, Enrique Ramón Botella, Joaquín Castro, Leyre Chasco, Juan Criado, Cristina de Ancos, J. del Toro, Pablo Demelo‐Rodríguez, A.M. Díaz-Brasero, MC Díaz‐Pedroche, J.A. Díaz‐Peromingo, MV Di Campli, Álvaro Dubois-Silva, J.C. Escribano, F. Espósito, Ana Isabel Farfán‐Sedano, Carmen Fernández‐Capitán, JL Fernández‐Reyes, MA Fidalgo, Katia Flores, Carme Font, Llorenç Font, Iria Francisco, Cristina Gabara, Francisco Galeano‐Valle, M.A. García, F. García‐Bragado, Marta García de Herreros, RG de la Garza, Catarino García-Díaz, A. Gil-Díaz, Covadonga Gómez‐Cuervo, E Grau, L. Guirado, Juan Mata, Luis Blasco, Luis Jara‐Palomares, M.J. Jaras, David Jiménez, Ruth Jiménez Castuera, Carmen Jiménez-Alfaro, M.D. Joya, S. Lainez-Justo, Antonio Lalueza, A. Latorre, Jorge Roberto Perrout de Lima, JL Lobo, Luciano López-Jiménez, Patricia López-Miguel, J J López-Núñez, Raquel López-Reyes, J.B. López‐Sáez, A. Lorenzo, Olga Madridano, Ana M. Maestre, P.J. Marchena, M. Martín del Pozo, F. Martín‐Martos, Diego Martínez‐Urbistondo, C Mella, MI Mercado, Jorge Moisés, Manuel Monréal, Arturo Muñoz Blanco, J.A. Nieto, E Nofuentes‐Pérez, MJ Núñez‐Fernández, M. Olid-Velilla, M.C. Olivares, Jeisson Osorio, S. Otálora, Remedios Otero, Diana Paredes-Ruíz, JM Pedrajas, JA Porras, Joaquin Portillo, Isabel Redondo, Consolación Rodríguez-Matute, Vitória Silva da Rosa, Pedro Ruiz‐Artacho, Justo Ruiz-Ruiz, G. Salgueiro, R. Sánchez‐Martínez, JF Sánchez‐Muñoz‐Torrero, Teresa Sancho, S. Soler, Beatriz Suárez-Rodríguez, J.M. Suriñach, MI Torres, Andrea Torres-Sánchez, Carlos Tolosa, Javier Trujillo‐Santos, Fernando Uresandi, B. Valero, R. Valle, J.F. Varona, Lydia Vela, J. C. De Coll Vela, G. Vidal, A. Villalobos, Paula Villares, Carles Zamora, Cihan Ay, Stephan Nopp, Ingrid Pabinger, MM Engelen, Thomas Vanassche, Peter Verhamme, Jana Hirmerová, Radován Malý, Sandrine Accassat, Nassim Ait Abdallah, Laurent Bertoletti, A. Bura-Rivière, Judith Catella, Françis Couturaud, Benjamin Crichi, P. Debourdeau, Olivier Espitia, Dominique Farge, C. Grangé, H. L. Helfer, Karine Lacut, Raphaël Le Mao, I. Mahé, Pierre‐Emmanuel Morange, Farès Moustafa, Géraldine Poenou, G. Sarlon-Bartoli, Pierre Suchon, I. Quéré, Sebastian Schellong, Andrei Braester, Barry E. Brenner, Gili Kenet, Inna Tzoran, Manuela Basaglia, Franca Bilora, Cristiano Bortoluzzi, B. Brandolin, Maurizio Ciammaichella, Antonina De Angelis, P. Di Micco, Egidio Imbalzano, Simona Merla, Raffaele Pesavento, Paolo Prandoni, Carmine Siniscalchi, Antonella Tufano, A. Visonà, Ngoc Vo Hong, Beniamino Zalunardo, Yuji Nishimoto, Yukihito Sato, Kristīne Maķe, Andris Skride, Sintija Strautmane, S. Fonseca, Filipa Abreu Martins, J. Meireles, Marijan Bosevski, H Bounameaux, Lucia Mazzolai, JA Caprini, HM Bui,

Organ Transplantation Techniques and Outcomes

The association between elevated liver enzymes or FIB-4 (fibrosis index 4) and outcome in patients with venous thromboembolism (VTE) has not been evaluated. Data from patients in RIETE (Registro Informatizado Enfermedad TromboEmbólica) were used to assess the association between elevated liver enzymes or FIB-4 levels and the rates of major bleeding or death in apparent liver disease-free patients with acute VTE under anticoagulation therapy. A total of 6206 patients with acute VTE and without liver disease were included. Of them, 92 patients had major bleeding and 168 died under anticoagulation therapy. On multivariable analysis, patients with elevated liver enzymes were at increased mortality risk (HR: 1.58; 95% CI: 1.10-2.28), while those with FIB-4 levels > 2.67 points were at increased risk for major bleeding (HR: 1.69; 95% CI: 1.04-2.74). Evaluation of liver enzymes and FIB-4 index at baseline in liver disease-free patients with VTE may provide additional information on the risk for major bleeding or death during anticoagulation.